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Dietary Reference Intakes: Applications in Dietary Assessment (2000)
Institute of Medicine (IOM)

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. "6 Using the Tolerable Upper Intake Level for Nutrient Assessment of Groups." Dietary Reference Intakes: Applications in Dietary Assessment. Washington, DC: The National Academies Press, 2000.

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DRI DIETARY REFERENCE INTAKES: Applications in Dietary Assessment

FIGURE 6-2 Population potentially at risk from excessive nutrient intakes. The fraction of the population consistently consuming a nutrient at intake levels in excess of the Tolerable Upper Intake Level (UL) is potentially at risk of adverse health effects. Additional information is necessary to judge the significance of the risk.

some portion of the population has intakes above the UL, a risk may exist and the need to take action to reduce population intakes should be evaluated. For example, the UL for niacin for adults is 35 mg/day. The LOAEL for niacin is 50 mg/day and the uncertainty factor is 1.5 (indicating a good level of confidence in the data). The adverse effect noted is a relatively benign vasodilation causing flushing of the skin that may be accompanied by a burning, itching, or tingling sensation; this effect is readily reversible by a reduction in intake. The UL for vitamin B6 is 100 mg/day for adults and the NOAEL is 200 mg/day with a UF of 2. The adverse effect observed—sensory neuropathy—is a serious and irreversible condition. Therefore, public health concern over a segment of the population routinely consuming niacin in excess of the UL would not be as great as if a segment of the population were routinely consuming vitamin B6 in excess of the UL.

Figure 6-3 illustrates a situation in which usual dietary intake from foods represents no discernible risk but the addition of intakes from supplement usage makes a fraction of the population potentially at risk. Figure 6-4 represents the type of analysis that would apply when

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122
Front Matter (R1-R14)
Contents (R15-R18)
Summary (1-18)
I. Historical Perspective and Background (19-20)
1 Introduction and Background (21-28)
2 Current Uses of Dietary Reference Standards (29-42)
II. Application of DRIs for Individual Diet Assessment (43-44)
3 Using Dietary Reference Intakes for Nutrient Assessment of Individuals (45-70)
III. Application of DRIs for Group Diet Assessment (71-72)
4 Using the Estimated Average Requirement for Nutrient Assessment of Groups (73-105)
5 Using the Adequate Intake for Nutrient Assessment of Groups (106-112)
6 Using the Tolerable Upper Intake Level for Nutrient Assessment of Groups (113-126)
7 Specific Applications: Assessing Nutrient Intakes of Groups Using the Dietary Reference Intakes (127-144)
IV. Fine-Tuning Dietary Assessment Using the DRIs (145-146)
8 Minimizing Potential Errors in Assessing Group and Individual Intakes (147-161)
9 Research Recommended to Improve the Uses of Dietary Reference Intakes (162-167)
10 References (168-178)
Appendix A: Origin and Framework of the Development of Dietary Reference Intakes (179-184)
Appendix B: Nutrient Assessment of Individuals: Statistical Foundations (185-202)
Appendix C: Assessing Prevalence of Inadequate Intakes for Groups: Statistical Foundations (203-210)
Appendix D: Assessing the Performance of the EAR Cut-Point Method for Estimating Prevalence (211-231)
Appendix E: Units of Observation: Assessing Nutrient Adequacy Using Household and Population Data (232-238)
Appendix F: Rationale for Setting Adequate Intakes (239-253)
Appendix G: Glossary and Abbreviations (254-261)
Appendix H: Biographical Sketches of Subcommittee Members (262-266)
Index (267-281)
Summary Table: Estimated Average Requirements (282-283)
Summary Table: Tolerable Upper Intake Levels (284-286)
Summary Table: Recommended Intakes for Individuals (287-289)